Kopta S M, Lueger R J, Saunders S M, Howard K I
Department of Psychology, University of Evansville, Indiana 47722, USA.
Annu Rev Psychol. 1999;50:441-69. doi: 10.1146/annurev.psych.50.1.441.
Psychotherapy is facing challenges that relate to the emergence of managed health care, the possibility of a national health care system, and advances in biological psychiatry. These situations have created pressure to achieve a more accurate assessment of psychotherapeutic effectiveness. Psychotherapy has been proven to be generally effective; however, there is uncertainty as to why. The field is currently experiencing apparent turmoil in three areas: (a) theory development for psychotherapeutic effectiveness, (b) research design, and (c) treatment technique. This chapter reviews the dynamics within each of the areas and highlights the progress made in treating mental disorders. We conclude that recent advances in research design may provide a transition that will bring psychotherapy closer to becoming a unified paradigm with an acceptable theory of effectiveness.
心理治疗正面临着与管理式医疗保健的出现、国家医疗保健系统的可能性以及生物精神病学的进展相关的挑战。这些情况产生了压力，要求对心理治疗效果进行更准确的评估。心理治疗已被证明总体上是有效的；然而，其原因尚不确定。该领域目前在三个方面正经历明显的混乱：（a）心理治疗效果的理论发展，（b）研究设计，以及（c）治疗技术。本章回顾了每个领域内的动态，并突出了在治疗精神障碍方面取得的进展。我们得出结论，研究设计方面的最新进展可能会提供一个过渡，使心理治疗更接近成为一个具有可接受的有效性理论的统一范式。
